title: A preliminary RCT of CBT-AD for adherence and depression among HIV-positive Latinos on the U.S.-Mexico border: the Nuevo Día study.
abstract: We conducted a preliminary RCT among 40 HIV-positive Latinos of Mexican descent on the U.S.-Mexico border who indicated imperfect adherence and depressive symptomatology. Participants were randomly assigned to culturally adapted cognitive-behavioral therapy for adherence and depression with an alarmed pillbox or usual care. Outcomes were depressive symptoms (self-report and blind clinician ratings), adherence (self-report and electronic pillbox), and biological markers. The intervention, delivered in English and Spanish, proved feasible and acceptable. Generalized estimating equations in intent-to-treat analyses showed some effects of "moderate" to "large" size, with maintenance over time. For example, intervention (vs. control) participants demonstrated at post-intervention a greater drop in BDI scores (OR = -3.64, p = 0.05) and greater adherence according to the electronic pillbox (OR = 3.78, p = 0.03). Biological markers indicated some relative improvement for CD4 count but not VL. The promising results suggest a larger trial to determine efficacy is warranted.
authors.affiliation: Department of Psychology, University of Washington, 3909 W. Stevens Way NE, Campus Box 351525, Seattle, WA, 98195-1525, USA, jsimoni@uw.edu.
authors.forename: Jane M
authors.initials: JM
authors.lastname: Simoni
authors.forename: John S
authors.initials: JS
authors.lastname: Wiebe
authors.forename: John A
authors.initials: JA
authors.lastname: Sauceda
authors.forename: David
authors.initials: D
authors.lastname: Huh
authors.forename: Giselle
authors.initials: G
authors.lastname: Sanchez
authors.forename: Virginia
authors.initials: V
authors.lastname: Longoria
authors.forename: C
authors.initials: C
authors.lastname: Andres Bedoya
authors.forename: Steven A
authors.initials: SA
authors.lastname: Safren
mesh_terms: D000328:Adult; D018791:CD4 Lymphocyte Count; D015928:Cognitive Behavioral Therapy; D003863:Depression / Q000188:drug therapy / Q000453:epidemiology*; D005240:Feasibility Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology*; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D010349:Patient Compliance; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D019562:Viral Load; D016903:Drug Monitoring